What initial first aid measures should be taken for a scald injury in children?

Initial first aid measures for a scald injury in children include:

• Ensure the area is safe and wear personal protective equipment if necessary to avoid personal injury.
• Assess the child's airway, breathing, and circulation immediately, as respiratory failure can be life-threatening and children are at increased risk of circulatory compromise.
• Stop the burning process promptly (e.g., extinguish flames or remove the child from the source of heat).
• Remove non-adherent clothing and any potentially restricting jewellery carefully; do not attempt to remove tar stuck to the skin.
• Within 20 minutes of the injury, cool the burn by irrigating with cool or tepid running water for 15–30 minutes to remove heat, prevent progression of injury, reduce pain, clean the wound, and minimize swelling.
• Avoid using ice or very cold water as this may cause further tissue damage and hypothermia.
• If running water is unavailable, use wet towels or compresses for cooling.
• Keep the child warm during and after cooling to prevent hypothermia, especially when large areas are cooled.
• After cooling, cover the burn with cling film laid over the burn (not wrapped circumferentially) to prevent bacterial colonization, wound drying, and relieve pain; if cling film is unavailable, use a clean cotton sheet or a clear plastic bag for burns to the hand.
• Do not apply topical creams at this stage as they may hinder wound assessment.
• Elevate the affected area if possible to reduce swelling and oedema.
• Offer appropriate pain relief such as paracetamol or ibuprofen; consider adding codeine for more severe pain.
• Take a history and assess burn severity to determine if urgent hospital admission is required or if management in primary care is appropriate.

These steps help improve healing, reduce pain and distress, and improve long-term cosmetic and functional outcomes.

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